1. Field of the Invention
The present invention relates to surgical devices for use in fixating soft tissue to bone and, more particularly, to such devices for fixating soft tissue within a bone tunnel.
2. Description of Related Art
Orthopedic surgical procedures sometimes require an attachment (or reattachment) of a flexible member to a bone. The flexible member might comprise soft tissue such as a ligament or tendon, a synthetic element, or suture. Devices and methods are known in the art to accomplish such an attachment, including those for affixing the flexible member within a hole of the bone.
For example, it is known to use a member such as a screw to press at least one end of the flexible member against the interior wall of a bone space (Mahony, U.S. Pat. No. 5,062,843; Roger et al., U.S. Pat. No. 5,383,878; Steininger et al., U.S. Pat. No. 5,425,767; Huebner, U.S. Pat. No. 5,454,811; Laboureau, EU 0 317 406). It is also known to anchor a ligament between two elements, the inner one deformable (U.S. Pat. No. 5,108,431), and to pass a ligament through a center of a device, creating tension by relative movement of elements (DeSatnick, U.S. Pat. No. 5,571,184). It is further known to affix an implant to a bone surface (Hunt et al., U.S. Pat. No. 4,590,928).
In the general field of prosthetic ligaments, it is known to use a autograft or allograft to replace a length of connective tissue (Goble et al., U.S. Pat. Nos. 4,772,286; 4,870,957; 4,927,421; 4,997,433; 5,129,902; 5,147,362; U.S. Pat. No. Re. 34,293; Kurland, U.S. Pat. No. 4,400,833; Jurgutis, U.S. Pat. No. 4,467,478; Hilal et al., U.S. Pat. No. 4,597,766; Seedhom et al., U.S. Pat. No. 4,668,233; Parr et al., U.S. Pat. No. 4,744,793; Van Kampen, U.S. Pat. No. 4,834,752; Rosenberg, U.S. Pat. No. 5,139,520). Dore et al. teach the use of a tension spring for use as an artificial prosthetic ligament (U.S. Pat. No. 4,301,551).
Devices are also known for driving and affixing soft tissue to a desired site, typically a bone (Seedhom et al., U.S. Pat. No. 4,668,233; Daniel et al., U.S. Pat. No. 4,712,542; Goble et al., '902; Rosenberg, U.S. Pat. No. 5,139,520).
An additional problem includes the establishment and maintenance of a desired tension in a graft in order to provide optimal postoperative mobility and support. This has been addressed by Daniel et al. ('542) and by Goble et al. (U.S. Pat. Nos. 5,037,426; 5,713,897).
A particular surgery in which flexible member attachment is required is the reattachment of soft tissue, such as is required in the affixing of a ligament to a bone. A particular procedure is the reattachment of an anterior cruciate ligament or the attachment of a graft within a bone tunnel.
However, there is no known effective device and method for pretensioning the soft tissue/graft to a known preload without the use of a separate tensioning system, which is advantageous in restoring optimal physiological operation. Nor is there known to be such a device and method for attaching a soft tissue/graft within a bone tunnel wherein the a substantial portion of the load is borne by the bone exterior.